Medical perspectives (Medicni perspektivi)

12-17

Authors: Shatorna V.F., Garetz V.I., Biletska E.M.*, Onul N.М.*, Nefyodova O.O., Ostrovskа S.S., Stepanov S.V., Dihno N.I.

Among modern investigations in nanobiotechnology, only a small part of them is devoted to the influence of nanometals on reproductive organs and embryogenesis. Thus, if functions of the separate trace metals are studied well enough, the physiological role of such ultramicroelements as gold is still poorly studied especially in the field of its interaction with other metals. The aim of the research was an experimental study of peculiarities of gold aquananocitrate and lead acetate interaction and their impact on rats’ embryogenesis under condition of combined administration. There were used solutions of lead acetate and citrate gold in experimental models obtained by aquananotehnology. Solutions of metals and nanometals were injected perorally once a day during 19 days of pregnancy: solution of lead acetate in the dose of 0.05 mg/kg and gold aquananocitrate solution in the dose of 1.5 mg/kg. 3 group - control group. Influence of tested substances was assessed by integral and specific indicators using physiological, morphological and quantitative analysis methods. It was established that lead acetate in the dose of 0.05 mg/kg is characterized by severe embryotoxic effect manifested by total embryonic mortality, and reducing number of live fetuses in the offspring. Combined introduction of gold aquananocitrate and lead acetate weakens embryotoxic effect of lead, manifested by increase of corpora lutea number by 30.4%, increase of offspring number by 53.3% and decrease of fetal mortality by 2.3 times.

25-32

Authors: Pertseva T.A., Kireyeva T.V., Kravchenko N.K.

Bronchial asthma (BA) is the most common respiratory disease in pregnancy. About 20% of pregnant women experience asthma exacerbations of varying severity, while 5.8% of them require hospitalization. Objective: to study asthma course during pregnancy by determining clinical and functional characteristics of the disease, taking into account presence of exacerbations and adherence to basic therapy (BT). Materials and methods: The study included 35 pregnant females (Me ± SD) aged 31±5,28 years, gestational age – 34±6,69 weeks. Anamnestic and physical data, spirometry and assessment of asthma control using Control Asthma Test were conducted. Results: In the study group 71% of pregnant women suffered from aggravation of varying severity developing on the background of symptoms of respiratory tract infection. Here with commitment to BT before and during pregnancy significantly did not differ. Inconsistency of BT to severity of the disease in 25% of women with mild and in 36% with moderate asthma course was detected.

39-45

Authors: Krutikov S.N., Krivorutchenko Yu.L., Postnikova O.N., Krutikova M.S., Logadir T.A.

Dependence of prevalence and severity of bacteremia on the rate of liver impairment, serum bactericidal activity (SBA), and serum concentrations of C-reactive protein (CRP) and granulocyte colony-stimulating factor (G-CSF) in 80 hospitalized patients with liver cirrhosis (LC) have been studied. It was shown that risk factors associated with the development of bacteremia are high by Child-Pugh score and low SBA, CRP and G-CSF levels. Patients with LC, class A had the highest SBA, CRP and G-CSF levels. Still 14,3% of them developed less severe bacteremia associated with one type of microorganisms isolated from blood. Patients with LC, class B had intermediate SBA, CRP and G-CSF levels. They developed severe bacteremia in 52,6% of cases and less severe bacteremia – in 21,1% of cases. Patients with LC, class C had low SBA, CRP and G-CSF levels. They developed severe bacteremia in 62,5% of cases and less severe bacteremia – in 25% of cases.

53-60

Authors: Bielosludtseva K.O.

Questions of management of patients with severe community acquired pneumonia (CAP) in HIV-infected are particularly acute. Pneumonia etiology, identification and treatment on the background of immune deficiency, its clinical and diagnostic features and tactics are still not clearly described, this significantly increases mortality from CAP in general clinical practice. That is why the aim of the work was to determine clinical features, etiology, severity of systemic inflammation and cellular immunity status of severe pneumonia in HIV-infected individuals. For this, 62 patients with verified severe CAP were observed, after express testing the main group included 11 (17.7%) persons with severe CAP and identified HIV-infection who underwent identification of respiratory pathogens, determination of serum levels of markers of systemic inflammation (procalcitonin (PCT) and C-reactive protein (CRP)), count of CD4, CD8, CD4/CD8 lymphocyte subpopulations. According to the results of causative agent identification in the study group pneumonia caused by Pneumocystis jirivecii (in 9 (81.8%) of cases) dominated, whereas in 2 other patients (18.2%) Streptococcus pneumonia was identified. According to the results of objective examination it turned out that the peculiarities of severe CAP in HIV infected patients is non-manifestal atypical clinical set of symptoms with predominance of respiratory distress syndrome over general intoxication, due to Pneumocystis pathogenetic mechanisms of lung injury (BR in the study group was at 37,5±0,1 per 1 min. of oxygen saturation 79,2±3,0%), and with following minimal inflammatory processes (maximum level of PCT in patients with pneumocystis pneumonia corresponded 0.555 ng/ml). According to the study of cellular immunitit it was found that of study group patients had CD4 count 65% less than in the control group. It turned out that in cases of suspected severe CAP in HIV-infectsd patients sputum PCR method allows to quickly detect atypical respiratory pathogens (including Pneumocystis). Determination of serum levels of biomarkers allows to be oriented towards the cause of severity state of patients with severe CAP, and the need in antibiotic therapy. Determination of CD4, CD8, CD4/CD8 markers has high differential diagnostic value in patients with severe CAP and HIV infection, especially in the absence of evidence of immunodeficiency.

64-71

Authors: Bilіanskyі L.S., Svіsenko O.V., Netesa S.I.

Research purpose was to investigate tissue reactions on implantation of polypropylene mesh, processed with collagen, after plastic surgery of experimental defect in rats in preperitoneal prosthesis localization. Research was performed in two experimental groups. Group 1 – in 17 rats an experimental defect of anterior abdominal wall with 3 cm of size with further preperitoneal fixation of the polypropylene mesh of 0,5×1,0 cm size was performed. Group 2 – in 20 rats under analogous conditions preperitoneal fixation of polypropylene mesh, processed with collagen was performed. Morphological analysis of stages of scar tissue formation in the implantation region in the preperitoneal cavity of rats by stereological characteristics of cellular and fiber structures of connective tissue considering hemodynamic characteristics shows substantial benefits of polypropylene mesh, processed with collagen, during 2 montha after experimental hernioplasty.

78-85

Authors: Volkov O.O.

In obstetrics postoperative cognitive dysfunctions may take place after caesarean section and vaginal delivery with poor results both for mother and child. The goal was to study influence of anesthesia techniques following caesarian section on memory, perception and speech. Having agreed with local ethics committee and obtained informed consent depending on anesthesia method, pregnant women were divided into 2 groups: 1st group (n=31) had spinal anesthesia, 2nd group (n=34) – total intravenous anesthesia. Spinal anesthesia: 1.8-2.2 mLs of hyperbaric 0.5% bupivacaine. ТIVА: Thiopental sodium (4 mgs kg-1), succinylcholine (1-1.5 mgs kg-1). Phentanyl (10-5-3 μgs kg-1 hour) and Diazepam (10 mgs) were used after newborn extraction. We used Luria’s test for memory assessment, perception was studied by test “recognition of time”. Speech was studied by test "name of fingers". Control points: 1 - before the surgery, 2 - in 24h after the caesarian section, 3 - on day 3 after surgery, 4 - at discharge from hospital (5-7th day). The study showed that initially decreased memory level in expectant mothers regressed along with the time after caesarean section. Memory is restored in 3 days after surgery regardless of anesthesia techniques. In spinal anesthesia on 5-7th postoperative day memory level exceeds that of used in total intravenous anesthesia. The perception and speech do not depend on the term of postoperative period. Anesthesia technique does not influence perception and speech restoration after caesarean sections.

92-97

Authors: Mokiya- Serbinа S.A., Chechel V.V.

Features of the development of cognitive functions in children 5-6 years of age with iron deficiency (ID) were studied and the relationship of the revealed features of iron deficiency degree was established. After clinical and laboratory examination 205 children aged 5-6 years, pupils of pre-school institutions were included in the study. The core group consisted of 155 children, including 105 children with latent iron deficiency (LID) and 50 children with iron deficiency anemia (IDA) I degree. The control group consisted of 50 healthy children. To study cognitive function, "Approximate comprehensive program of study of children's readiness for school" was used. A significant decrease of average data of all mental functions (perception, memory, language, thinking, imagination) in children 5-6 years old with ID, most pronounced in children with IDA was revealed. Indicators of cognitive functions correspond predominantly to a mild and moderate level of development in children with IDA, the average - in children with LID, good and high - in healthy children. There was a significant direct correlation between the level of cognitive functioning and the level of hemoglobin, serum iron and ferritin. The effect of iron deficiency on the development of indicators of cognitive function toward their reduce in preschool children was established. The level of cognitive functioning depends on the degree of iron deficiency.

103-107

Authors: Vyklyuk I.V., Ozhogan Z.R.

The need of Ukrainian population in treating damaged parts of the tooth crown is 36-53 % of all patients, individually made root - casted cores are commonly used in practical dentistry. Using teeth roots for prosthesis has many advantages and allows to preserve integrity of the dentition, prevents premature atrophy of the alveolar bone and occurrence of dentoalveolar deformities. We have developed and practically implemented method of restoring tooth abutment by changing its axis in periodontal disease. During performing of the work we have carried out clinical examination of 127 patients with existing teeth and roots of teeth and periodontal disease. Defining of dentition parameters was performed by our method and by the proposed device, which determines angle of the root axis and its distance from the occlusal plane of dentition. As a result of our investigation, by measuring deviation of axis of crown tooth relatively dental arch, it was found that deviation from the axis in the vestibulo- oral direction prevailed within 3-7° in 1 degree of severity and 8-11° – in 2 degree of generalized periodontitis severity. By the results of measurements and X-ray examination one can assertain that roots with inclination of 3° to 15°, previously prepared endodontically, are suitable to restoration with adhesive root - crown systems as the base for orthopedic splinting constructions of dentures.

112-122

Authors: Yepanchintseva О.А.

Postoperative arterial fibrillation (AF) is one of the most common complication after cardiac surgery . POAF affect the length of hospital stay, incidence of postoperative stroke and mortality. The main factors of postoperative AF include age, gender, left atrial size, presence of AF before surgery. The most effective drugs to prevent POAF are beta-blockers and amiodarone. In many cases statins, blockers of the renin -angiotensin system are prescribed. Clinical management of patients with POFP and urgency of restoring sinus rhythm are determined by hemodynamic parameters. In unstable hemodynamic condition electrical cardioversion is performed.

130-138

Authors: Biletska E.M., Onul N.M., Bezub O.V.

For today problem of chemical contamination of the environment and inner enviroment of the organism is extremely topical. Among all toxicants scientists pay special attention to lead, as it is characterized by a global prevalence in the enviroment and polytropic action on the human organism. Aim of the work – on the basis of analytical generalization of research data to establish peculiarities of lead impact on formation and functioning of bone tissue, calcium balance in the organism. It was determined that despite a low external exposure of metal, in man’s biosubstrates its levels are much higher than allowable. Herewith bone tissue due to its anatomyphysiology peculiarities accumulates lead selectively, forming inner additional source of its impact on the organism, potentiating toxic impact of xenobiotic. Therefore biomonitoring data on lead content in bone tissue is an important informative finding not only of danger but of duration, permanence and complex impact on the organism.

144-151

Authors: Vavrinevych E.P., Omelchuk S.T., Bardov V.G., Bilous S.V.

Nowadays in Ukraine there is a trend of increased use of mixed fungicides, containing compounds of certain classes in the formulation and new classes of active substances including anilinopyrimidines compounds. The aim of our work was hygienic assessment of dynamics of anilinopyrimidines pesticide residues in the soil, pit fruits, pomes fruits, vegetables, grapes and estimation of their risk for population. The content of tested substances in the samples was determined by gas-liquid and high performance liquid chromatography. Full-scale field studies have shown that in soil and climatic conditions of Ukraine dynamics of residues of anilinopyrimidines obeys an exponential dependence. Mean values of anilinopyrimidines fungicides τ50 were equal to 10.7±0.8 days in soil, 7.9±0.2 days – in fruits, 5.7±0.6 days – in verdurous plant mass. Pyrimethanil and cyprodinil (according to SsanN&R 8.8.1.002-98) were referred to class III of hazard by persistency in soil, and valifenal – to IV class; tested substances were classified as hazard pesticides class III by persistency in plants. Comparative analysis of degradation rates of tested compounds in different matrices showed that degradation processes occur significantly faster in the verdurous mass of plants than in the fruits (p<0.05; t=3,75); and in fruits – significantly faster than in the soil (p<0.05; t=3.35). 0.0413 mg of cyprodinil, 0.0555 mg of valifenal and 0.0385 mg of pyrimethanil can get into human body with daily food allowance, which is 3.3%, 26.4% and 4.6% of the acceptable daily intake, correspondingly. The data obtained will be used while making decision on registration of preparations containing this class of compounds in Ukraine.

159-161

Authors: Gumenyuk G.L.

We conducted a comparative survey of incidence and prevalence of pulmonary sarcoidosis in Southern (Crimean AR) and Northern (Zhytomyr region) regions of Ukraine by means of analysis of self-referred cases and cases, revealed at prophylactic radiological examination in 2011. The incidence of sarcoidosis in Crimea was 1.08 per 100 000 adult inhabitants; the prevalence was 4,59 per 100 000. In Zhytomyr region the incidence value (2,62 per 100 000) exceeded an equivalent value in Crimea by 2,4 times. The prevalence (7,86 per 100 000) was also higher than in Crimea by 1,7 times. Taking into account a significant impact of climate factor on sarcoidosis epidemiology, the incidence and prevalence of disease in Northern and Southern regions should be considered polar as for the regions of Ukraine. This makes it possoble to conclude that mean incidence of sarcoidosis in Ukraine ranges from 1,1 to 2,6 per 100 000 adult population, whereas the prevalence – from 4,6 to 7,9 per 100 000, which is equivalent to the level of Southern European countries.